<!DOCTYPE html>
<html xmlns:th="http://www.w3.org/1999/xhtml">
<meta charset="utf-8">
<head th:include="include :: header"></head>
<body class="gray-bg">
<div class="wrapper wrapper-content ">
    <div class="row">
        <div class="col-sm-12">
            <div class="ibox float-e-margins">
                <div class="ibox-content">
                    <form class="form-horizontal m-t" id="signupForm">
                        <div class="form-group">

                            <label class="col-sm-3 control-label">专家姓名（开户名）：</label>
                            <div class="col-sm-8">
                                <input id="expertName" name="expertName" placeholder="expertName" class="form-control"
                                       type="text">

                            </div>
                        </div>


                        <div class="form-group">
                            <label class="col-sm-3 control-label">批次id：</label>
                            <div class="col-sm-8">
                                <input id="batchId" name="batchId" placeholder="batchId" class="form-control"
                                       type="text">

                            </div>
                        </div>


                        <div class="form-group">
                            <label class="col-sm-3 control-label">专家类型：</label>
                            <div class="col-sm-8">
                                <input id="expertType" name="expertType" placeholder="expertType" class="form-control"
                                       type="text">

                            </div>
                        </div>

                        <div class="form-group">
                            <label class="col-sm-3 control-label">身份证号码：</label>
                            <div class="col-sm-8">
                                <input id="expertIdCard" name="expertIdCard" placeholder="expertIdCard" class="form-control"
                                       type="text">

                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">手机号：</label>
                            <div class="col-sm-8">
                                <input id="mobile" name="mobile" placeholder="mobile" class="form-control"
                                       type="text">

                            </div>
                        </div>

                        <div class="form-group">
                            <label class="col-sm-3 control-label">专家所属机构：</label>
                            <div class="col-sm-8">
                                <input id="expertOrgName" name="expertOrgName" placeholder="expertOrgName" class="form-control"
                                       type="text">

                            </div>
                        </div>

                        <div class="form-group">
                            <label class="col-sm-3 control-label">学校：</label>
                            <div class="col-sm-8">
                                <input id="examFeeIf" name="examFeeIf" placeholder="examFeeIf" class="form-control"
                                       type="text">

                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">年份：</label>
                            <div class="col-sm-8">
                                <input id="year" th:value="${year}" name="year" placeholder="year" class="form-control" type="text">

                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">劳务费：</label>
                            <div class="col-sm-8">
                                <input id="laborCost" name="laborCost" placeholder="laborCost" class="form-control"
                                       type="text">

                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">餐费：</label>
                            <div class="col-sm-8">
                                <input id="meals" name="meals" placeholder="meals" class="form-control" type="text">

                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">交通费(市内）：</label>
                            <div class="col-sm-8">
                                <input id="trafficExpense" name="trafficExpense" placeholder="trafficExpense"
                                       class="form-control" type="text">

                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">住宿费：</label>
                            <div class="col-sm-8">
                                <input id="hotelExpense" name="hotelExpense" placeholder="hotelExpense"
                                       class="form-control" type="text">

                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">邮费：</label>
                            <div class="col-sm-8">
                                <input id="postage" name="postage" placeholder="postage" class="form-control"
                                       type="text">

                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">大交通费用：</label>
                            <div class="col-sm-8">
                                <input id="trafficExpenseMax" name="trafficExpenseMax" placeholder="trafficExpenseMax"
                                       class="form-control" type="text">

                            </div>
                        </div>

                        <div class="form-group">
                            <label class="col-sm-3 control-label">其它费用：</label>
                            <div class="col-sm-8">
                                <input id="otherCost" name="otherCost" placeholder="otherCost" class="form-control"
                                       type="text">

                            </div>
                        </div>

                        <div class="form-group">
                            <label class="col-sm-3 control-label">银行账户：</label>
                            <div class="col-sm-8">
                                <input id="bankAccount" name="bankAccount" placeholder="bankAccount"
                                       class="form-control" type="text">

                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">开户银行：</label>
                            <div class="col-sm-8">
                                <input id="bankOfDeposit" name="bankOfDeposit" placeholder="bankOfDeposit"
                                       class="form-control" type="text">

                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">备注：</label>
                            <div class="col-sm-8">
                                <input id="remarks" name="remarks" placeholder="remarks" class="form-control"
                                       type="text">

                            </div>
                        </div>

                        <div class="form-group">
                            <div class="col-sm-8 col-sm-offset-3">
                                <button type="submit" class="btn btn-primary">提交</button>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
<div th:include="include::footer"></div>
<script src="//s.xlongwei.com/res/js/My97DatePicker/WdatePicker.js"></script>
<script type="text/javascript" src="/js/webJs/jzweb/refund/add.js">
</script>
</body>
</html>
